Retinal Microvascular Changes in Patients with Stroke

Abstract

Introduction: Stroke is a common manifestation of cerebrovascular disease. The common risk factors for stroke include hypertension and diabetes mellitus. Retinal and cerebral vessels have common embryological and anatomical characteristics; thus, they show similar patterns of damage from diseases. Therefore, examination of the fundus could provide a noninvasive view of intracranial vascular pathology.
Purpose: To examine the fundus of patients presenting with acute stroke to see prevalence of retinal findings and their correlation with stroke.
Material and Methods: This observational cross-sectional study was carried out among 50 patients with acute stroke presenting to medicine emergency of tertiary care teaching hospital in North India. Detailed medical history was taken and complete general physical examination was performed. Fundus was examined with the help of direct and indirect ophthalmoscopy. Data was analyzed with online software OpenEpi version 3. Chi square test was applied and p values <0.05 were considered statistically significant.
Results: The mean age in this study was 63.9 ± 13.8 years with male to female ratio of 3.16:1. There was a significant association between vessel attenuation, arterio-venous (AV) changes, hemorrhages, hard exudates and cotton spots among hypertensive patients with stroke (p value <0.05). Among the diabetic patients, AV changes, hemorrhages, hard exudates, cotton wool spots and neovascularization were significantly associated with stroke (p value <0.05).
Conclusion: Therefore, routine retinal examination is important in patients with stroke. Presence of retinal findings act as marker for underlying diseases such as hypertension and diabetes, providing risk stratification among individual patients.